Case of the Month – December 2010 – Breast Reconstruction Fat Grafting

Pre op

 

Pre op oblique

Intra operative acellular dermis placement

Intra operative acellular dermis placement

Post op initial reconstruction
Post op initial reconstruction
Post initial reconstruction oblique
Post initial reconstruction oblique

Post fat grafting

Post fat grafting

Post fat grafting oblique
Post fat grafting oblique

The patient presented post mastectomies with thin coverage and a peak shaped chest.  We discussed using latissimus flaps for improved coverage, but she wanted to avoid a more involved operation.  We used acellular dermis with the initial expander and implant reconstruction to improve the tissue thickness inferiorly and to keep the implants from sliding off the chest and into the axillae (arm pits).

She then had visible rippling secondary to the thin coverage.  This was improved with four sessions of fat grafting.  Note the decreased rippling, improved superior and medial transition from breast mound to chest.

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